A new Salmonella type is described, for which the name Salmonella seremban is proposed; it has the antigenic formula IX, XIII, XII 2, XIIa; i=l, 3, 5. It was the apparent cause of a number of human cases of food poisoning at Seremban, Malaya.
Sarcocystosis, an unusual parasitic zoonotic disease, is caused by coccidian/ apicomplexan protozoa in humans and animals. The parasites usually develop in a heteroxenous predator-prey life-cycle involving final (carnivore) and intermediate (omnivore/herbivore) hosts. Besides the intestinal, non-invasive form of the disease in which humans and animals are the definitive hosts for certain Sarcocystis spp., the invasive form has come to recent attention. In the latter, humans and animals serve as intermediate host harbouring sarcocysts in their muscle tissue. Already in 1991 sarcocystosis was seen as a potential emerging food borne zoonosis in Malaysia, and in 2011 and 2012 the largest cluster of symptomatic human muscular sarcocystosis world-wide was reported from Tioman Island, Pahang state. In this review, we focus on invasive sarcocystosis in humans and animals in Malaysia, review the recorded cases and epidemiology, and present hypotheses.
Tetrodotoxin poisoning has been commonly reported in Japan due to consumption of contaminated fugu (puffer fish). Poisoning is possible when the fish is not cleansed and dressed properly. Puffer fish is considered a delicacy by the Japanese as the fish meat is very tender and tasty. A certified chef trained in ways of preparing this poisonous fish should only be allowed to serve this fish. Despite careful preparation, this fish remains a deadly meal for many as 50 deaths are reported annually1 . An outbreak of 34 cases of tetrodotoxin occurred in Johor in May 2008. Here, we would like to report three cases of tetrodotoxin poisoning in a family who consumed this deadly fish and was admitted to Hospital Sultanah Aminah Johor Bahru (HSAJB).
We report the largest outbreak of brucellosis in Penang, Malaysia. Brucellosis is not endemic in this region. The index case was a 45-year-old goat farm owner presented with 3 weeks of fever, headache, severe lethargy, poor appetite, and excessive sweating. He claimed to have consumed unpasteurized goat's milk that he had also sold to the public. Tests were negative for tropical diseases (i.e., dengue fever, malaria, leptospirosis and scrub typhus) and blood culture showed no growth. Based on epidemiological clues, Brucella serology was ordered and returned positive. Over a period of 1 year, 79 patients who had consumed milk bought from the same farm were diagnosed with brucellosis. Two of these patients were workers on the farm. Four laboratory staff had also contracted the disease presumably through handling of the blood samples. The mean duration from onset of symptoms to diagnosis was 53 days with a maximum duration of 210 days. A combination treatment of rifampin and doxycycline for 6 weeks was the first line of treatment in 90.5% of patients. One-third of the patients had sequelae after recovering and 21% had a relapse. We highlight the importance of Brucellosis as a differential diagnosis when a patient has unexplained chronic fever.
Food borne diseases increase worldwide and contamination of food contact surfaces serves as one of the reasons for their occurrence. The aim of this study was to determine the microbiological quality of spoons at selected restaurants in Klang Valley, Malaysia. Five restaurants were selected therein for the study. They were respectively labelled A, B, C, D and E. A total of 150 cleaned spoons (30 spoons from each restaurants) that were ready to be used by customers at the restaurants were examined. Total plate counts (CFU/cm2) of the spoons were determined; the presumptive and confirmatory tests for the presence of Escherichia coli on the spoons were also conducted. The samples were collected by surface swabbing. The result showed that restaurant C and B had the highest and lowest total plate counts (TPC), respectively. Samples from 3 of the 5 selected restaurants (restaurants C, D and E) showed positive results for the presence of E. coli mainly due to poor dishware cleansing. On the contrary, negative results for the presence of E. coli at restaurant A and B were associated with the advance cleaning procedure, which used more hygienic method with dishwashers.
Prompt investigation of food poisoning outbreak are essential, as it usually involves a short incubation period. Utilizing the advancement in mobile technology, a mobile application named MyMAFI (My Mobile Apps for Field Investigation) was developed with the aim to be an alternative and better tool for current practices of field investigation of food poisoning outbreak. A randomized cross-over trial with two arms and two treatment periods was conducted to assess the effectiveness of the newly developed mobile application as compared to the standard paper-based format approach. Thirty-six public health inspectors from all districts in Kelantan participated in this study and they were randomized into two equal sized groups. Group A started the trial as control group using the paper-format investigation form via simulated outbreaks and group B used the mobile application. After a one-month 'washout period', the group was crossed over. The primary outcome measured was the time taken to complete the outbreak investigation. The treatment effects, the period effects and the period-by-treatment interaction were analyzed using Pkcross command in Stata software. There was a significant treatment effect with mean square 21840.5 and its corresponding F statistic 4.47 (p-value = 0.038), which indicated that the mobile application had significantly improve the reporting timeliness. The results also showed that there was a significant period effect (p-value = 0.025); however, the treatment by period interaction was not significant (p-value = 0.830). The newly developed mobile application-MyMAFI-can improve the timeliness in reporting for investigation of food poisoning outbreak.
A food poisoning outbreak affected 114 female Malay students staying in a religious secondary school hostel in Klang. The students developed an illness mainly characterized by abdominal pain, nausea, vomiting and giddiness. The median incubation period in this outbreak was 2.5 hours. Laboratory examination of suspected food revealed 2.3 X10^6 Bacillus cereus organisms per gram of fried noodles. B. cereus was determined as the probable cause of this outbreak and the fried. noodles the most likely vehicle for the organism. An outbreak of B. cereus food poisoning is being reported in Malaysia for the first time.
A 69-year-old lady who was referred by her general practitioner with a diagnosis of food poisoning developed cardiorespiratory arrest shortly after arriving at the Casualty Department. Cardiac output was successfully restored with resuscitation but she had to be mechanically ventilated due to the absence of any spontaneous respiratory effort. Assessment 24 hours after admission, showed fixed and dilated pupils with brain stem areflexia. Her family was told that the prognosis was hopeless. Surprisingly, her condition rapidly improved a day later and she eventually had a good recovery. Her condition was actually due to severe tetrodotoxin poisoning after eating roe of the puffer fish and it was fortunate that appropriate aggressive resuscitation was instituted to revive the patient from her critical state.
We report two cases of acute renal failure that followed the ingestion of jering. Features of jering poisoning included clinical presentation of bilateral loin pain, fever, nausea, vomiting, oligo-anuria, haematuria and passage of sandy particles in the urine. Blood urea (40.8 mmol/l; 21.9 mmol/l) and serum creatinine (1249 mumols/l; 693 mumols/l) were markedly elevated. With conservative therapy which included rehydration with normal saline and alkalinisation of the urine with sodium bicarbonate, the acute renal failure resolved.
The horseshoe crab (Carcinoscorpius rotundicauda) is consumed by those residing near the coastal areas of Kota Marudu District in Malaysia, as it is considered a delicacy. During June to August, 2011 thirty cases of tetrodotoxin poisoning were reported from Kota Marudu District following ingestion of horseshoe crabs caught in Kota Marudu Bay. The purpose of this study is to describe this case series in order to determine risk factors to prevent further outbreaks. There were six confirmed and 24 probable cases of tetrodotoxin poisoning identified in the study area during the study period as diagnosed by clinical presentation and laboratory findings. Symptoms included dizziness (80%), circumoral and lingual numbness (80%), hand and feet numbness (63.3%), nausea and vomiting (30%) and weakness and difficulty in breathing (26.6%). Three cases (10%) died while 27 cases recovered. Forty-seven percent of the cases had onset of symptoms within 30 minutes of ingestion and 14% 31-60 minutes after ingestion of horseshoe crab meat. Urine samples were collected from the cases, while horseshoe crabs, cockles and sea water from the epidemic area were also taken for analysis. Tetrodotoxin was detected in the urine of six cases; the highest concentrations recorded were among the three cases who died. High tetrodotoxin concentrations were found in the hepatic cecum and eggs of the tested horseshoe crabs. Dinoflagellates were not detected in the sea water or cockle samples. Intensive health education was initiated quickly to stop other members of the Marudu Bay community from consuming the horseshoe crabs. This is the first documented epidemic of tetrodotoxin poisoning in Sabah.
Sprouts have gained popularity worldwide due to their nutritional values and health benefits. The fact that their consumption has been associated with numerous outbreaks of foodborne illness threatens the $250 million market that this industry has established in the United States. Therefore, sprout manufacturers have utilized the U.S. Food and Drug Administration recommended application of 20,000 ppm of calcium hypochlorite solution to seeds before germination as a preventative method. Concentrations of up to 200 ppm of chlorine wash are also commonly used on sprouts. However, chlorine-based treatment achieves on average only 1- to 3-log reductions in bacteria and is associated with negative health and environmental issues. The search for alternative strategies has been widespread, involving chemical, biological, physical, and hurdle processes that can achieve up to 7-log reductions in bacteria in some cases. The compilation here of the current scientific data related to these techniques is used to compare their efficacy for ensuring the microbial safety of sprouts and their practicality for commercial producers. Of specific importance for alternative seed and sprout treatments is maintaining the industry-accepted germination rate of 95% and the sensorial attributes of the final product. This review provides an evaluation of suggested decontamination technologies for seeds and sprouts before, during, and after germination and concludes that thermal inactivation of seeds and irradiation of sprouts are the most practical stand-alone microbial safety interventions for sprout production.
Bacillus cereus (B. cereus) isolates are toxigenic and can cause food poisoning. Cooked rice is
a potentially hazardous food, especially in tropical countries. The aim of this study was to determine the prevalence of B. cereus and B. thuringiensis in raw and cooked rice marketed in Selangor, Malaysia. In this research combination of Most Probable Number - Polymerase Chain Reaction (MPN-PCR) was used to detect gyrB gene in B. cereus and B. thuringiensis. Five local varieties of raw rice samples were negative for B. thuringiensis but all (100%) were positive for B. cereus. A total of 115 cooked rice samples (nasi lemak, nasi briyani, nasi ayam and nasi putih) were studied for the presence of B. cereus and B. thuringiensis. Nasi ayam was found to have the highest prevalence (100%) of B. cereus compared to nasi putih (76.2%) and nasi lemak (70.4%). Nasi briyani had the lowest prevalence (50%) of B. cereus. The frequencies of B. thuringiensis were found to be 10, 30 and 35.2 % in nasi putih and nasi ayam, nasi briyani and nasi lemak, respectively. The range of B. cereus and B. thuringiensis in the samples was from < 3 to 1100 MPN/g in different samples. Maximum number of B. cereus was observed in nasi lemak, nasi briyani and nasi putih ( > 1100 MPN/g) while nasi ayam showed less contamination (460 MPN/g) with B. cereus which was significantly different (P < 0.05 ) from others. The number of B. thuringiensis in nasi lemak, nasi briyani, nasi putih and nasi ayam were found to be >1100, 93, 9.2 and 3.6 MPN/g, respectively.
In October 1988, a series of food poisoning cases occurred in the State of Perak in Malaysia. Most of the victims were children. Ultimately 13 children between the ages of 2.5 and 11 years died. Epidemiological investigations showed that the probable source of the poison was Loh See Fun, a noodles in the shape of a rat's tail. All the deceased ate the noodles from one supplier. Clinical and pathological findings were similar in each case. Postmortem examination was performed in 11 cases. Toxicological examination on organs in 10 cases showed a high concentration of aflatoxin in tissues of the deceased. High levels of boric acid were excreted from most of the victims. Histological examination of the liver in these cases showed necrotic changes found in aflatoxin poisoning. Combination of the epidemiological, clinical, toxicological, and pathological findings pointed to the fact that there was a common toxin or toxins responsible for the deaths. These were thought to be a combination of boric acid and aflatoxin.
Cross contamination is one of the most important contributing factors in foodborne illness
originating in household environments. The objective of this research was to determine the
transfer between naturally contaminated chicken liver and leg to cutting board, hand glove,
knife and cucumber, during slicing. The microorganism tested was Campylobacter jejuni and
the results showed that the pathogen transferred to all utensils, at different transfer rate, despite
the low level of the naturally contaminating pathogen. With unknown concentration bacteria in
the naturally contaminated samples, a proportion of the utensils were still contaminated with C.
jejuni and not surprisingly, when the sample were contaminated with higher concentrations of
the pathogen, a higher proportion of the utensils had detectable C. jejuni cells present, though
in many cases cross contamination seems to be a random event. Transfer of the naturally
contaminating C. jejuni from the chicken liver and leg to the utensils were
Campylobacter is globally recognized as a major cause of foodborne infection in humans, whilst the development of antimicrobial resistance and the possibility of repelling therapy increase the threat to public health. Poultry is the most frequent source of Campylobacter infection in humans, and southeast Asia is a global leader in poultry production, consumption, and exports. Though three of the world's top 20 most populated countries are located in southeast Asia, the true burden of Campylobacter infection in the region has not been fully elucidated. Based on published data, Campylobacter has been reported in humans, animals, and food commodities in the region. To our knowledge, this study is the first to review the status of human Campylobacter infection in southeast Asia and to discuss future perspectives. Gaining insight into the true burden of the infection and prevalence levels of Campylobacter spp. in the southeast Asian region is essential to ensuring global and regional food safety through facilitating improvements in surveillance systems, food safety regulations, and mitigation strategies.
Vibrio parahaemolyticus (V. parahaemolyticus) is a common foodborne pathogen that contributes to a large proportion of public health problems globally, significantly affecting the rate of human mortality and morbidity. Conventional methods for the detection of V. parahaemolyticus such as culture-based methods, immunological assays, and molecular-based methods require complicated sample handling and are time-consuming, tedious, and costly. Recently, biosensors have proven to be a promising and comprehensive detection method with the advantages of fast detection, cost-effectiveness, and practicality. This research focuses on developing a rapid method of detecting V. parahaemolyticus with high selectivity and sensitivity using the principles of DNA hybridization. In the work, characterization of synthesized polylactic acid-stabilized gold nanoparticles (PLA-AuNPs) was achieved using X-ray Diffraction (XRD), Ultraviolet-visible Spectroscopy (UV-Vis), Transmission Electron Microscopy (TEM), Field-emission Scanning Electron Microscopy (FESEM), and Cyclic Voltammetry (CV). We also carried out further testing of stability, sensitivity, and reproducibility of the PLA-AuNPs. We found that the PLA-AuNPs formed a sound structure of stabilized nanoparticles in aqueous solution. We also observed that the sensitivity improved as a result of the smaller charge transfer resistance (Rct) value and an increase of active surface area (0.41 cm2). The development of our DNA biosensor was based on modification of a screen-printed carbon electrode (SPCE) with PLA-AuNPs and using methylene blue (MB) as the redox indicator. We assessed the immobilization and hybridization events by differential pulse voltammetry (DPV). We found that complementary, non-complementary, and mismatched oligonucleotides were specifically distinguished by the fabricated biosensor. It also showed reliably sensitive detection in cross-reactivity studies against various food-borne pathogens and in the identification of V. parahaemolyticus in fresh cockles.